Wednesday, February 24, 2016

When To Place Your Loved One

A subject that comes up every now and then here on Mp is how do I know when it is time for placement?

First off, in my opinion, this topic should have been discussed a long time before placement is even an issue. When the patient can and will make what decisions they want for themselves.

The very week I was diagnosed we went to our attorneys office and changed our will, changed power of attorney of financial and medical.

And right after that, we talked about placement. Or rather I did. I understood what a toll this disease will be on my wife, and our family. The one thing I could to make this easier on everyone, especially Phyllis June, was to tell her my choices I want about placement.

Both of us being in EMS for over twenty five years, we have seen first hand situations where patients were kept at home that should not have been. Sometimes this is for financial reasons, sometimes over some promise made twenty years ago.

Whatever the case there almost always comes a time when no matter what the disease is be it dementia, cancer, paraplegic, whatever it is, in the end some families cannot care for their loved one properly.

This happens. It when it happens and the family realizes it and still does nothing is when the patient suffers. I have seen numerous cases where the patient is kept at home so the wife, kids, whoever can still get the checks in the mail.

It's crazy, but it happens. This is why I am all for talking about this placement thing long before it is ever even needed.

Too many times you will hear "I don't know what to do? I think placement is the only thing we can do? How do I go about placing my loved one? Who do I turn to?

First off, the subject of placement should have already been discussed with the patient, long before this is an issue. I cannot stress that enough. If you don't, you will have world war three with some family members, simply because everyone knows best.

If you have in the patients will their wishes to be placed, then the argument is over before it even starts.

Now, how do you go about this? Well first off, no one can just place their loved one. All of this must go through their primary physician. Only a doctor can evaluate and decide that someone is indeed needing 24hr round the clock care.

You can't just drive up to your local nursing facility that you like, take Mom in and announce that you are there for a room for Mom. It doesn't work that way.

Even if their doctor does agree and orders placement in a facility, that facility has requirements. One of which is who is paying for this and how.

Every state differs but there is criteria you must meet for placement financially. The facility is a business and they will want their money.

If the patient for instance owns any property like a house, land, a car, a boat, any property like that and they will be considered private pay until said property is sold.

In Ohio for example the patient cannot have any property or funds in their banking account that is over $1500. If they do, they are private pay. Like I said up to and until these assets are gone.

If for instance Dad has $8,000 in the bank, he will be on private pay until that amount is less than $1500. This is just the way it works in Ohio. The spouse however has to be allowed to stay in the home, even if its owed on or paid for.

But when the end comes, the house and property it sits on must be sold to pay back whatever assistance your loved one was one. Be in medicare, or whatever.

The facility wants their money, and will get if from the State, but the State will get their money in the end also. By forcing a sale of the house.

This all seems a little barbaric, but no facility is in business of giving out free room and board. If they were, they wouldn't be in business.

I have said many times this dementia thing is a billion dollar industry. If you notice, they are now building entire dementia facilities, instead of just having a dozen or so rooms for dementia patients.

The more rooms they have for dementia patients the more money they will make. So they now build entire dementia facilities.

The very best thing you can do is have a plan. Some think they take what money there is and hide it, move it to another account, whatever. Then apply for Gov't assistance.

Don't do this. There are people in the Gov.t who do nothing then look for things like this. They are called the IRS. And it is called fraud.

I wish we would have known this, but even if we would have it wouldn't have changed anything for us. We did put the house and everything else in Phyllis Junes name.

We have seven years to wait, up to seven years, that transition doesn't mean anything. In other words the IRS looks at that as moving money or property around to defraud the nursing home by getting Gov't assistance.

Take for instance Mom has $70,000 in savings, bonds, and IRA's. You just can't liquidate that money into your account or someone else's. There is what they call a money trail.

This money has to be show as spent, not just moved from Mom's account into the daughters or whoever. It sounds good and you would think you could do that.

If you do, and if she gets assistance, someone will pay in the end. These facilities keep track of things like money and who's paying what. And so does the IRS.

Just figure on Mom being private pay until her assets are gone. Then she can and will get assistance.

So, have a plan. Then have another. This thinking you can just pick out a nursing facility and drive up and drop Mom off isn't how it works.

Placement can take weeks. If for instance there just isn't any rooms where you want your loved one to be at the time. You can't arrange for a room in advance.

I hope this helps just one person who is on this journey. You may be told to contact an elder law attorney. That is fine. But that costs money. Many times you have services in your area like Job & Family Services that can help you with talking about placement and what to do. And these places are free.

An elder law attorney could cost you way over a thousand dollars for the same advice you can get at a Job & Family Services for free. So do your homework. And don't wait till its time for placement.

You can always plan and change your mind. There is never a downside to placing your loved one too soon. There are many downsides to waiting too long, and none of them are good.

©  Rick Phelps 2016